Individual
AVA ROSE MAI DICIERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 STEPHEN DR, FARMINGDALE, NY 11735-6138
(516) 512-2354
Mailing address
3 STEPHEN DR, FARMINGDALE, NY 11735-6138
(516) 512-2354
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
346279
NY
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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